Multislice CT (MSCT) in the detection and classification of pelvic and acetabular fractures

Purpose: To assess the usefulness of MSCT in the detection and classification of pelvic and acetabular fractures. Materials and Methods: Routine radiographs and MSCT of the pelvis with sagittal and coronal multiplanar reconstruction (MPR) were performed in 50 patients with clinically suspected pelvic or acetabular fractures. One trauma surgeon and a radiologist evaluated routine radiographs and CT images in terms of fracture detection, classification and visualization. The AO classification of fractures was used. Results: NISCT excluded a suspected fracture in 15 patients. In the remaining 35 patients, 19 anterior pelvic ring fractures, 10 anterior and posterior pelvic ring fractures, 8 acetabular fractures and 4 sacral fractures were diagnosed. All NISCT diagnoses were made from the axial source images. In 7 (17 %) patients, MSCT detected additional fractures (2 acetabular and 5 posterior pelvic ring fractures) not seen on conventional radiographs. In 3 other patients, MSCT changed the fracture classification by delineating the full extent of the fracture. MPR visualized 7 acetabular and 4 sacral fractures better than the axial source images. Conclusions: MSCT of the pelvis is needed for correct fracture detection and classification and has therapeutic consequences.